LIFE MEDICAL, P.A.
NPI 1740222496
Clinic/Center - Multi-Specialty in Saint Louis Park, MN
About Life Medical, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIFE MEDICAL, P.A. (NPI 1740222496), doing business as Life Medical, is a healthcare organization registered as a multi-specialty in Saint Louis Park, Minnesota and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through December 10, 2026 and lists Jacob I Mirman, Managing Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Life Medical, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Life Medical, P.A., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 11 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 11
Clinicians, nearest first (16)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D1062275
Life Medical, PA · Saint Louis Park, MNFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Life Medical, P.A.'s NPI number?
The NPI number for Life Medical, P.A. is 1740222496. It was assigned to this organization in the NPPES registry on June 10, 2006. The provider is doing business as Life Medical.
Where is Life Medical, P.A. located?
Life Medical, P.A. is located at 4201 Excelsior Blvd, Saint Louis Park, MN 55416. The listed phone number is (952) 933-1121.
What is Life Medical, P.A.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Life Medical, P.A. enrolled in Medicare?
Yes. Life Medical, P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Life Medical, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 11 Medicare specialties reassign their Medicare billing to Life Medical, P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Chiropractic (3), Internal Medicine (3) and Family Practice (2). Of these, 4 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Life Medical, P.A. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D1062275) is associated with this NPI, valid through December 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Life Medical, P.A. accept?
Health plans from HealthPartners list Life Medical, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Life Medical, P.A. was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Life Medical, P.a. · NPI 1740222496
Multi-Specialty organization in Saint Louis Park, Minnesota. Organization record, active in the CMS NPPES registry since June 10, 2006.
## Identity
- **NPI:** 1740222496 (Entity type: Organization)
- **Enumerated:** June 10, 2006
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Also known as:** Life Medical (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Jacob Mirman, MANAGING PARTNER
## Practice location
- **Address:** 4201 EXCELSIOR BLVD, Saint Louis Park, MN 55416-4728
- **Phone:** (952) 933-1121 · **Fax:** (952) 945-9536
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 16 clinicians in 11 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Chiropractic (3), Internal Medicine (3), Family Practice (2); 4 practice at this address and 11 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 18, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1740222496) · Data from the CMS NPPES public registry.